Doc-in-a-Box Retail Clinics Popping Up in the Best
of Neighborhoods, Not Underserved
States with large elderly populations lead in
locations Florida, California, Texas, Illinois and Georgia
Your Sick, Were Quick says sign in photo by
Consumer Reports
read more.
May 26, 2009 - Despite early reports indicating
that placement of retail clinics are determined by physician shortages
and higher uninsured populations, these clinics appear to be located in
more advantaged neighborhoods, according to a report in the May 25 issue
of Archives of Internal Medicine, one of the JAMA/Archives
journals.
"Retail clinics are medical clinics located within
larger retail outlets that are usually staffed by nurse practitioners
and supervised by an off-site physician," according to the article.
Retail clinics usually focus on urgent care and routine preventive
services, such as immunizations. (Read more about these clinics below
news report.)
These facilities tend to be open on nights and
weekends, usually provide service without appointments and tend to have
lower prices than those charged by primary care physicians or emergency
departments.
Craig Evan Pollack, M.D., M.H.S. and Katrina
Armstrong, M.D., M.S.C.E., of the Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, mapped locations of
retail clinics as of July 2008 and linked them to the 2000 U.S. Census
and 2008 Health Resources and Services Administration data to determine
if the clinics are typically located in areas with higher medical need.
"A total of 930 retail clinics were geocoded to the
continental United States. Eighteen states (37 percent) had no retail
clinics, and 17 states (35 percent) had 25 or more clinics," the authors
write.
Five states had more than 50 clinics including
Florida (112), California (90), Texas (85), Illinois (58) and Georgia
(56).
Retail clinics were located in 908 census tracts
within 247 counties. Ninety-six percent of counties with retail clinics
were classified as metropolitan areas.
"Counties with retail clinics had lower rates of
uninsured individuals (12.1 percent vs. 13.3 percent)," the authors
write.
"Compared with census tracts without retail
clinics, those tracts with retail clinics had a lower percentage of
black and Hispanic individuals, fewer rental units and lower rates of
poverty. In addition, the census tracts had residents with higher median
incomes and higher rates of home ownership."
"If retail clinics are determined to be a valuable
and effective source of care, rethinking the distribution of these
clinics may be an important avenue for improving their potential
societal benefit," the authors conclude.
"With nearly a third of chain stores located in
medically underserved areas, the future expansion of retail clinics into
existing stores could potentially improve access for underserved
populations."
Editor's Note: The Robert Wood Johnson Foundation
Clinical Scholars Program at the University of Pennsylvania provided
funding for this research.
About Convenient Care Clinics
The original idea may have been to further
affordable and convenient health care for minorities and those with less
income, but the market has pushed them to emphasize the speed of service
- faster service than patients will find at hospitals, emergency rooms
or the doctors office.
The association that has emerged to represent these
clinics is named the Convenient Care Association and one of the newest
retail outlets is named FastCare Clinic in
Aberdeen, South Dakota.
This new clinic will address a specific need in
our community, said Todd Forkel, Vice President of Clinic and Network
Operations at Avera St. Lukes that opened the story. It offers
convenience and quick care for families with minor healthcare needs.
For people without a family doctor, or during weekends or after hours,
this type of service is more efficient and less expensive than using the
hospitals emergency department.
Doc in a Box - An Insider's Perspective, Dec.
15, 2008
Rod Moser, a Physician's Assistant and PhD, wrote
about these clinics for Web MD:
"In the past, people
would crowd the emergency rooms with these "minor urgencies", grouped in
with the auto accident victims and the drunks. Waiting for hours and
hours to be seen is commonplace since the more-serious cases are seen
first. The emergence of these quicky-care facilities are hoping to fill
the void when you just need to see a medical provider...NOW.
"The pharmacy-based
clinics set up by our medical organization are basically little,
free-standing kiosks consisting of one examining room and a tiny area
with a computer to register patients, make chart notes, etc. There is no
lab or x-ray. All of them are staffed by nurse practitioners for 12-hour
shifts. It can take up the 30 minutes per patient, since the clinician
has to register the patient, check insurance eligibility, take the
payment or co-payment, as well as examine the patient and complete the
chart notes. Basically, the clinician is their own front desk person and
medical assistant."
The Convenient Care
Association is the association of companies and healthcare systems that
provide consumers with accessible, affordable, quality healthcare in
retail-based locations. CCA works primarily to enhance and sustain the
growth of the Convenient Care industry through sharing of best practices
and common standards of operation. The CCA was founded in October 2006.
Since the first
Convenient Care clinics (CCCs) opened in 2000, the Convenient Care
industry has grown quickly. Today there are approximately 1,200 such
clinics in operation, and CCA member clinics represent more than 95% of
the industry. To date, CCCs have served more than 3.5 million patients.
The original idea may have been to further
affordable and convenient health care for minorities and those with less
income, but the market has pushed them to emphasize the speed of service
- faster service than patients will find at hospitals, emergency rooms
or the doctors office.